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The Efficacy and Safety of Gynomax® XL Vaginal Ovule in the Treatment of Common Vaginal Infections: A Single-Arm Clinical Trial, Gyno-Türk
Received: 27 Aug 2021 | Accepted: 04 Jan 2022 | Available online: 18 Jan 2022Erol TAVMERGENa, Ferruh ACETa, Cüneyt Eftal TANERb, Fatih DURMUŞOĞLUc, Yaprak ÜSTÜNd, Berna DİLBAZd, Fatma Feriha ÇİLLİe
aDepartment of Obstetrics and Gynecology, Ege University Faculty of Medicine, İzmir, TURKEY
bDepartment of Obstetrics and Gynecology, İzmir University of Health Sciences Tepecik Training and Research Hospital, İzmir, TURKEY
cClinic of Obstetrics and Gynecology, Hisar Hospital, İstanbul, TURKEY
dDepartment of Obstetrics and Gynecology, University of Health Sciences Etlik Zübeyde Hanım Training and Research Hospital, Ankara, TURKEY
eDepartment of Microbiology, Ege University Faculty of Medicine, İzmir, TURKEY
JCOG. 2021;31(4):120-8
DOI: 10.5336/jcog.2021-85924
Article Language: EN
Copyright Ⓒ 2024 by Türkiye Klinikleri. This is an open access article under the CC BY-NC-ND license (
http://creativecommons.org/licenses/by-nc-nd/4.0/)
ABSTRACT
Objective: The objective of this study was to evaluate the efficacy, safety, and tolerability of Gynomax® XL vaginal ovule in the treatment of bacterial vaginosis (BV), candidal vulvovaginitis (CVV), trichomonal vaginitis (TV), and mixed vaginal infections (MVI). Material and Methods: A total of 98 women diagnosed clinically with BV, CVV, TV, or MVI have completed this study. Patients were given Gynomax® XL for 3 consecutive days, and approximately 10 (+/-5) days after the treatment, a follow-up visit was conducted. In addition to the clinical examinations, vaginal swab samples were collected in both visits for microbiological tests. Results: Based on the clinical diagnosis of the investigators, most of the patients had MVIs (54.1%), followed by BV (24.5%) and CVV (20.4%) at the baseline visit. One (1.0%) patient was diagnosed as having TV. According to the microbiologic examination results, 44 (44.9%) patients had BV, 20 (20.4%) had CVV, and 13 (13.3%) had MVIs. According to the clinical findings, overall complete recovery (CR) was observed in 76.5% of the patients and according to the microbiologic findings, overall CR was observed in 85.7% of the patients. Microbiologic results evaluated by each diagnostic criterion showed that CR was detected in 93.2%, 85.0%, and 61.5% of the patients with BV, CVV, and MVIs, respectively. There were no serious or non-serious adverse events leading to patient withdrawal or treatment discontinuation during this study. Conclusion: Gynomax® XL vaginal ovules administered once daily for three consecutive days provide effective and safe treatment in patients with BV, CVV, and MVIs.
REFERENCES:- Hainer BL, Gibson MV. Vaginitis. Am Fam Physician. 2011;83(7):807-15. [PubMed]
- Mårdh PA, Tchoudomirova K, Elshibly S, Hellberg D. Symptoms and signs in single and mixed genital infections. Int J Gynaecol Obstet. 1998;63(2):145-52. [Crossref] [PubMed]
- Govender L, Hoosen AA, Moodley J, Moodley P, Sturm AW. Bacterial vaginosis and associated infections in pregnancy. Int J Gynaecol Obstet. 1996;55(1):23-8. [Crossref] [PubMed]
- Redondo-Lopez V, Meriwether C, Schmitt C, Opitz M, Cook R, Sobel JD. Vulvovaginal candidiasis complicating recurrent bacterial vaginosis. Sex Transm Dis. 1990;17(1):51-3. [Crossref] [PubMed]
- Sheeley A. Sorting out common causes of abnormal vaginal discharge. JAAPA. 2004;17(10):15-6, 18-20, 22. [PubMed]
- Sawyer PR, Brogden RN, Pinder RM, Speight TM, Avery GS. Tinidazole: a review of its antiprotozoal activity and therapeutic efficacy. Drugs. 1976;11(6):423-40. [Crossref] [PubMed]
- Fung HB, Doan TL. Tinidazole: a nitroimidazole antiprotozoal agent. Clin Ther. 2005;27(12):1859-84. [Crossref] [PubMed]
- Sobel JD. Vaginal infections in adult women. Med Clin North Am. 1990;74(6):1573-602. [Crossref] [PubMed]
- Meri T, Jokiranta TS, Suhonen L, Meri S. Resistance of Trichomonas vaginalis to metronidazole: report of the first three cases from Finland and optimization of in vitro susceptibility testing under various oxygen concentrations. J Clin Microbiol. 2000;38(2):763-7. [Crossref] [PubMed] [PMC]
- Heeres J, Meerpoel L, Lewi P. Conazoles. Molecules. 2010;15(6):4129-88. [Crossref] [PubMed] [PMC]
- Jevons S, Gymer GE, Brammer KW, Cox DA, Leeming MR. Antifungal activity of tioconazole (UK-20,349), a new imidazole derivative. Antimicrob Agents Chemother. 1979;15(4):597-602. [Crossref] [PubMed] [PMC]
- Donadio C. Tioconazole 2% cream in the treatment of Trichomonas vaginalis or mixed vaginal infections. J Int Med Res. 1986;14(1):50-2. [PubMed]
- Clissold SP, Heel RC. Tioconazole. A review of its antimicrobial activity and therapeutic use in superficial mycoses. Drugs. 1986;31(1):29-51. [Crossref] [PubMed]
- American Hospital Formulary Service (AHFS), Tioconazole: American Hospital Formulary Service (AHFS), Publication by the American Society of Health-System Pharmacists (ASHP). Bethesda. 2010:3522.
- Martell B, Kushner H, Richardson E, Mize A, Mayer P. Pharmacokinetics of lidocaine and its metabolites following vaginal administration of lidocaine gel to healthy female subjects. Clin Pharmacol Drug Dev. 2017;6(1):27-35. [Crossref] [PubMed] [PMC]
- Sherrard J, Wilson J, Donders G, Mendling W, Jensen JS. 2018 European (IUSTI/WHO) International Union against sexually transmitted infections (IUSTI) World Health Organisation (WHO) guideline on the management of vaginal discharge. Int J STD AIDS. 2018;29(13):1258-72. [Crossref] [PubMed]
- Nugent RP, Krohn MA, Hillier SL. Reliability of diagnosing bacterial vaginosis is improved by a standardized method of gram stain interpretation. J Clin Microbiol. 1991;29(2):297-301. [Crossref] [PubMed] [PMC]
- Abbaspoor Z, Rabee Z, Najjar S. Efficacy and safety of oral tinidazole and metronidazole in treatment of bacterial vaginosis: a randomized control trial. IJPR. 2014;4(2):78-83. [Crossref]
- Regidor PA, Sailer M. Open prospective study to evaluate the efficacy of a new vaginal pessary Containing 300 mg Tinidazole, 200 mg Tioconazole and 100 mg Lidocaine with a 3-day Regime (GynomaxXL®) in the treatment of vaginal infections due to bacterial vaginosis, candidiasis and mixed infections. Biomed J Sci & Tech Res. 2019;(12):5. [Crossref]
- Paladine HL, Desai UA. Vaginitis: diagnosis and treatment. Am Fam Physician. 2018;97(5):321-9. [PubMed]
- Schwebke JR, Gaydos CA, Nyirjesy P, Paradis S, Kodsi S, Cooper CK. Diagnostic performance of a molecular test versus clinician assessment of vaginitis. J Clin Microbiol. 2018;56(6):e00252-18. [Crossref] [PubMed] [PMC]
- Ozyurt E, Toykuliyeva MB, Danilyans IL, Morton O, Baktir G. Efficacy of 7-day treatment with metronidazole+miconazole (Neo-Penotran)-a triple-active pessary for the treatment of single and mixed vaginal infections. Int J Gynaecol Obstet. 2001;74(1):35-43. [Crossref] [PubMed]
- Taner CE, Elveren B, Mun S, Aydemir S. Efficacy and safety of metronidazole and miconazole nitrate and lidocaine combination for common vaginal infections. Farmaci and Terapia. 2006;(23);3-4:69-70.
- Workowski KA, Bolan GA; Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep. 2015;64(RR-03):1-137. Erratum in: MMWR Recomm Rep. 2015;64(33):924. [PubMed] [PMC]
- Thulkar J, Kriplani A, Agarwal N. A comparative study of oral single dose of metronidazole, tinidazole, secnidazole and ornidazole in bacterial vaginosis. Indian J Pharmacol. 2012;44(2):243-5. [Crossref] [PubMed] [PMC]
- Raja IM, Basavareddy A, Mukherjee D, Meher BR. Randomized, double-blind, comparative study of oral metronidazole and tinidazole in treatment of bacterial vaginosis. Indian J Pharmacol. 2016;48(6):654-8. [Crossref] [PubMed] [PMC]
- LiverTox: Clinical and research information on drug-induced liver injury [Internet]. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases; 2012-. [PubMed]
- Mayekar RV, Kandhari KV, Bhosale AA, Nandanwar YS, Gaikwad SM. A prospective study to compare the efficacy and safety of tioconazole and clotrimazole vaginal gel in patients suffering from vulvovaginal candidiasis. Int J Reprod Contracept Obstet Gynecol. 2016;5(12):4184-8. [Crossref]
- Armstrong NR, Wilson JD. Tinidazole in the treatment of bacterial vaginosis. Int J Womens Health. 2010;1:59-65. [Crossref] [PubMed] [PMC]
- Cribby S, Taylor M, Reid G. Vaginal microbiota and the use of probiotics. Interdiscip Perspect Infect Dis. 2008;2008:256490. [Crossref] [PubMed] [PMC]